失代偿期肝硬化患者胃粘膜和血浆ghrelin改变及其临床意义

Expression of ghrelin in gastric mucosa and serum ghrelin level in patients with decompensated cirrhosis

目的探讨失代偿期肝硬化患者胃粘膜和血浆中ghrelin的变化。方法采用sp法检测36例肝硬化患者胃黏膜ghrelin的表达,采用ELISA法检测血浆ghrelin水平。结果失代偿期肝硬化患者胃粘膜ghrelin表达及血浆ghrelin均高于无腹水者(21.29%±4.51%对16.97%±5.51%,P<0.05;4.52±3.61ng/ml对2.21±2.03ng/ml,P<0.05),肝硬化合并肝肾综合征患者较无肝肾综合征患者胃粘膜ghrelin表达无明显差别(19.51%±6.35%对17.97%±5.17%,P>0.05),而血浆ghrelin却明显增高(4.76±3.45ng/ml对2.13±1.96ng/ml,P<0.05)。结论ghrelin的增高对失代偿期肝硬化的形成和发展起一定的作用。血中ghrelin水平的升高与肾功能障碍有密切关系。

Objective To investigate the expression of ghrelin in gastric mucosa and serum ghrelin level in patients with decompensated cirrhosis. Method The expression of ghrelin in gastric mucosa was detected by immunohistochemical method and serum ghrelin level was by ELISA. Result The expression of ghrelin in gastric mucosa and serum ghrelin level in patients with decompensated cirrhosis were much higher than in compensated patients （21. 29%±4. 51% vs. 16. 97%±5.51%,P〈0.05;4.52±3.61ng/ml vs. 2.21±2. 03ng/mh P〈0.05）; The serum ghrelin level in cirrhotics with was much higher than in without hepatorenal syndrome （4.76±3.45ng/ml vs. 2.13±1.96ng/ml, P〈0. 05）, while the expression of ghrelin in gastric mucosa was in the same level in both the patients. Conclusion The increased ghrelin takes part in the pathogenesis of decompensated cirrhosis, and the high serum ghrelin level is related to the renal deficiency.